Herbal remedies. Chasteberry (vitex agnus castus; aka agnus castus fruit extract) has been reported as being helpful for easing premenstrual symptoms such as irritability, anger, headache and breast fullness. Herbs commonly used in traditional Chinese medicine (TCM) to ease PMS symptoms and to tonify the uterus include dang gui (angelica sinensis; aka Chinese angelica), bupleurum root (Ch: chai hu; radix bupleuri), poria (fu ling; sclerotium poriae cocos), tangerine peel (chen pi; pericarpium citri reticulatae), licorice root (gan cao; radix glycyrrhizae), white peony root (bai shao; radix paeoniae), mint leaf (bo he; herba menthae) and gingko biloba (bai guo).

Medical treatments and psychotherapy are used when the symptoms are more severe. These include:

• Cognitive behavioural therapy which can help with problems such as anxiety and depression
• Non-steroidal anti-inflammatory drugs for aches and pains
• Oral contraceptive pills to stop ovulation and stabilise hormone levels, which can help to combat mood swings
• Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) may be the most effective treatment for PMDD and severe PMS for the relief of fatigue, depressed moods and sleep problems.
• Gonadotropin-releasing hormone analogue therapy (GnRH-a) is used when all else fails. These synthetic hormones create a temporary menopause and stop your periods by blocking the production of oestrogen and progesterone. Significant side effects include osteoporosis (thinning of bone)

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